{
  "abstract": "Background With global population ageing, frailty poses a growing public-health challenge. Many countries have promoted social participation to mitigate frailty among older adults, but the cross-national consistency of this association remains unclear.Methods We harmonised data from four longitudinal cohort studies (N=20 947) conducted in England, the USA, China and Mexico with respect to measures of social participation and frailty. We employed fixed-effects models and cross-national meta-analyses to examine the longitudinal relationship between social participation and frailty. The Arellano-Bond estimator model was further used to evaluate the lagged effects of this association. Finally, a multilevel analysis incorporating country-level factors was conducted to investigate the moderating effects of macro-level variables.Results Substantial differences in social participation were observed across countries, ranging from 41.76% in Mexico to 83.43% in the USA. After adjusting for confounders, higher social participation was significantly associated with lower frailty levels (pooled effect=−0.52; 95% CI −0.80 to −0.24), with evidence of a lagged temporal effect. Neither the strength of this association nor the overall rate of social participation was significantly influenced by country-level factors.Conclusion The consistent findings across diverse national contexts suggest that promoting equitable social engagement among older adults may effectively reduce the prevalence of frailty. Public-health policies and community programmes should prioritise initiatives that encourage social participation among the elderly, and healthcare services may consider integrating social activities into routine care to foster active ageing.",
  "authors": [
    {
      "affiliations": [
        "Academy of Medical Science, Shanxi Medical University, Taiyuan, Shanxi, China",
        "School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China"
      ],
      "name": "Yiheng Ma"
    },
    {
      "affiliations": [
        "Department of Rehabilitation Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China"
      ],
      "name": "Shifeng Meng"
    },
    {
      "affiliations": [
        "Department of Rehabilitation Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China"
      ],
      "name": "Junying Wu"
    }
  ],
  "title": "Impact of social participation on frailty among older adults: a multinational cohort study from the USA, England, China and Mexico",
  "uid": "c7ee4497-7286-560b-817b-eaf8454ff778"
}